Acne vulgaris - Chronic
Definition
A chronic disorder of the pilosebaceous unit affecting almost everyone at one time or another .
Medical History
* Cleanser and Moisturizer use
* Cosmetic use
* Corticosteroid use
* Skin reaction irritant
* Increased androgen level
* Oral contraception
Findings
* Acne keloid
* Acne nodule
* Closed comedone
* Ice-pick acne scar
* Open comedone
* Papular eruption
* Post-inflammatory hyperpigmentation
* Pustule
Differential Diagnosis
* Rosacea
* Folliculitis
* Gram-negative folliculitis
* Plane wart
* Perioral dermatitis
* Milia
* Steroid acne
* Chlorine acne
* Pseudofolliculitis barbae
* Acne fulminans
* Hidradenitis suppurativa
* Miliaria
* Fibrous skin tumor of tuberous sclerosis
* Nodular elastosis with cysts AND comedones of Favre and Racouchot
* Acne cosmetica
* Acne mechanica
* Neonatal acne
* Acne conglobata
* Excoriated acne
* Pyoderma faciale
Treatment
Drug Therapy
Mild to moderate acne
BENZOYL PEROXIDE
Adults: Apply to affected area once or twice daily
TRETINOIN (Related toxicological information in TRETINOIN AND RELATED AGENTS)
Adults: Apply to affected area once nightly
ADAPALENE
Adults: Apply to affected area once daily
TAZAROTENE
Adults: Apply to affected area once nightly
ERYTHROMYCIN
Adults: 250-500 mg orally two to four times daily
CLINDAMYCIN HYDROCHLORIDE
Adults: 150 mg orally once or twice daily
SALICYLIC ACID (Related toxicological information in SALICYLATES)
Adults: Apply to affected area once or twice daily
AZELAIC ACID (Related toxicological information in AZELAIC ACID)
Adults: Apply to affected area once or twice daily
SULFACETAMIDE SODIUM
Adults: Apply to affected area once or twice daily
DOXYCYCLINE
Adults: 50-100 mg orally once or twice daily
MINOCYCLINE HYDROCHLORIDE
Adults: 50-100 mg orally once or twice daily
TETRACYCLINE
Adults: 250-500 mg orally once or twice daily
SULFAMETHOXAZOLE/TRIMETHOPRIM
Adults: 1 double-strength tab (trimethoprim 160 mg/sulfamethoxazole 800 mg) orally twice daily
ETHINYL ESTRADIOL/NORETHINDRONE ACETATE
ETHINYL ESTRADIOL/NORGESTIMATE
SPIRONOLACTONE
Adults: 50-200 mg orally daily in divided doses
Nonpregnant patients with severe acne
ISOTRETINOIN (Related toxicological information in ISOTRETINOIN)
Adults: 0.5-1 mg/kg/day orally in divided doses
Acne vulgaris in patients 12 years and older
CLINDAMYCIN PHOSPHATE/TRETINOIN
Adults: At bedtime, place a pea-sized amount on one fingertip and dot onto chin, cheeks, nose, and forehead, then rub over the entire face
Pediatrics (?12 years): At bedtime, place a pea-sized amount on one fingertip and dot onto chin, cheeks, nose, and forehead, then rub over the entire face
Non-Procedural Therapy
Acne vulgaris
* Skin Care
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